RT Journal Article SR Electronic T1 Ventilator dependence complications in motor neuron disease JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2020-002560 DO 10.1136/bmjspcare-2020-002560 A1 Felicity Dewhurst A1 Joanna Elverson A1 Amanda Mccleery A1 Jolene Brown A1 Robert McConnell A1 Owen Lever A1 Thomas Doris A1 Ben Messer A1 Andrew Hughes YR 2020 UL http://spcare.bmj.com/content/early/2020/09/20/bmjspcare-2020-002560.abstract AB Long-term dependence on non-invasive ventilation (NIV) without time for advance care planning can result in significant complications that may require innovative management strategies. We present the case of a man who was admitted with respiratory failure and required NIV. Despite effective treatment for community acquired pneumonia, attempts to wean NIV failed. While dependent on NIV, a diagnosis of motor neuron disease was made. Time without ventilation was not tolerated and consequently complications of: facial pressure ulceration, nasal septal prolapse, inspissated secretions and failure to feed occurred. This case illustrates the severity of complications that can result from NIV dependence; however, it also details how these can be effectively managed by the hospice multidisciplinary team, with support from experts both within and external to the hospice enabling the acquisition of appropriate skills and knowledge.